Friday, February 26, 2010

CBT and low back pain

Lower back pain is a very common problem and affects one in three adults in the U.K. each year with an estimated 2.5 million people seeking help from their GP. There is thought to be a psychological component to low back pain and researchers at Warwick University have been looking into the effectiveness of CBT (cognitive behaviour therapy) in treating it. They studied 701 people with back pain of whom 468 had six sessions of CBT. Those participants who received CBT saw their pain and disability levels fall twice as much as the other group.

You can find out more about this research at

Personality and post-natal depression

There are well established links between people's personality, the way they think about the world and their vulnerability to depression but it is less clear whether these factors have the same influence on people's tendency to develop postnatal depression. A team of researchers led by Lisa Jones from the University of Birmingham carried out a study of 447 women. 143 had had postnatal depression, 131 had had children and had had depression but not postnatal depression and 173 made up a healthy control group. Both the groups who had suffered from depression had higher levels of neuroticism (a tendency to get anxious and depressed about things) and dysfunctional beliefs and lower self-esteem than the other women but there were no significant differences between the women who had suffered from postnatal depression and those who had depression at other times.

Jones, Lisa ... [et al] - Cognitive style, personality and vulnerability to postnatal depression British Journal of Psychiatry March 2010, 196(3), 200-205

What patients think about involuntary treatment

All over the world large numbers of people are admitted to psychiatric hospitals. The laws governing this are controversial and in the U.K. are governed by the 2007 Mental Health Act. Most laws are based on the assumption that people who are compulsorily admitted to hospital do not recognise their need for care at the time so research has tended to concentrate on whether - looking back on things - people think it was a good idea that they received treatment. A team of researchers, led by Stefan Priebe from Newham Centre for Mental Health, London led a study of 1,613 people in 11 different countries. They were interviewed within a week of admission and again after a month and three months. The number of people who were happy with the decision to involuntarily treat them varied a lot between the different countries and ranged from 71% in Italy to 39% in Lithuania after a month and from 46% in Sweden to 86% in Italy after three months. (The figures for England were 47% and 54% respectively.) Women, people living alone and people with schizophrenia were more likely to be unhappy with their admissions.

Priebe, Stefan ... [et al] - Patients' views of involuntary hospital admission after 1 and 3 months: prospective study in 11 European countries British Journal of Psychiatry March 2010, 196(3), 179-185

Thursday, February 25, 2010

Binge drinking and the military: abstinence makes the will grow stronger

In 2008 nearly 185,000 new members were recruited to the U.S. armed forces. Navy and air-force personnel are forbidden to drink alcohol and smoke during their basic training and researchers from RTI international in North Carolina looked at how much people drank before and after starting their basic training. They studied 4,962 young adults, aged between 18 and 25 and found that 43.1% of them had engaged in binge drinking during the month before their basic training, 27.3% of whom could be described as frequent heavy episodic drinkers. This was higher than the average for the rest of the population but the rates after basic training were much lower with 12% being infrequent heavy episodic drinkers and only 9% frequent heavy episodic drinkers. This suggests that although the forces recruit from a pool of heavy drinkers the abstinence involved in basic training reduces this significantly. Over time the rates of binge drinking among the participants climbed again but to nowhere near the levels they had been before.

Bray, Robert M. ... [et al] - Alcohol use after forced abstinence in basic training among United States Navy and Air Force trainees Journal of Studies on Alcohol and Drugs January 2010, 71(1), 15-22

Tobacco, drug use and genetics

Around 60% of adolescents have smoked a cigarette at some point in their lives and around a third have smoked during the last month. Tobacco is often seen as a gateway to cannabis and other drugs but some scientists dispute this 'gateway' theory and suggest that there is a common genetic factor that links tobacco smoking and cannabis use. Researchers from the University of Amsterdam studied 3,744 Finnish twins and found that the 'total variation in the initiation of illicit drugs' was down to starting smoking (40%) genetic factors (32%) common environmental factors (20%) and unique environmental factors i.e. factors experienced by only one of the twins (8%) suggesting that tobacco use was marginally more important than genetics in predicting illegal drug use.

Huizink, Anja C. ... [et al] - Tobacco, cannabis, and other illicit drug use among Finnish adolescent twins: causal relationship or correlated liabilities Journal of Studies on Alcohol and Drugs January 2010, 71(1), 5-14

Young people, mental health and the Internet

Young people often find it difficult to access mainstream mental-health services partly because of the stigma associated with mental-health problems. One way round this is to use the Internet and a team of researchers from University College Cork surveyed 922 college students, aged between 18 and 24 to find out what they thought about doing this. 72.4% of the participants used the Internet several times a day and 30.8% had previously searched for mental-health information online, mostly for depression. 68% said they would use the Internet for mental-health support if they needed to but 79.4% said they would still prefer face-to-face support.

Horgan, A. and Sweeney, J. - Young students' use of the Internet for mental health, information and support Journal of Psychiatric and Mental Health Nursing 2010. 513), 117-123

Boys, girls and ADHD

Little is known about the effects of gender, on ADHD over time and on the links between ADHD and other mental-health problems. Researchers from Massachusetts General Hospital and the State University of New York studied 471 children with ADHD in a long-term study and found that both sexes showed a similar decline in ADHD symptoms as the children got older. However, girls were more likely to 'carry over' mental-health problems from childhood to adolescence, even allowing for the influence of adolescent ADHD.

Monuteaux, Michael C. ... [et al] - The influence of sex on the course and psychiatric correlates of ADHD from childhood to adolescence: a longitudinal study Journal of Child Psychology and Psychiatry March 2010, 51(3), 233-241

ADHD and time perception

People with ADHD (Attention Deficit Hyperactivity Disorder) often have problems with their perception of time but it is unclear whether this is due to difficulties in estimating how much time has elapsed or by the fact that they become distracted by other things. A team of researchers from Taipei looked into this issue in a study of 258 children aged between 10 and 17, 168 of whom had ADHD. In one task children had to press a button for the same length of time that a green circle was lit up on a screen. In another task the children did the same thing but had to count numbers while they estimated the time. The children with ADHD were worse at estimating the time in both tasks but their performance grew worse as the task got more complicated suggesting that attention played a more important part than time perception per se.

Hwang, Shoou-Lian ... [et al] - Deficits in interval timing measured by the dual-task paradigm among children and adolescents with attention-deficit/hyperactivity disorder Journal of Child Psychology and Psychiatry March 2010, 51(3), 223-232

Wednesday, February 24, 2010

Exercise, illness and anxiety

Having a chronic illness can sometimes lead to the development of anxiety - something that can lower people's quality of life and make them less likely to follow their treatment plans. Researchers from the University of Georgia have been looking into the effectiveness of exercise in reducing this anxiety in a review of 40 studies covering nearly 3,000 patients with a variety of medical conditions. The researchers found that, on average, the patients who exercised regularly reported a 20% reduction in anxiety symptoms. Exercise sessions greater than 30 minutes were better at reducing anxiety than those of less than 30 minutes but programmes of exercise of between 3-12 weeks were actually more effective than those of more than 12 weeks- perhaps because they were less daunting for the participants.

You can find out more about this research at

Belief in a caring God and depression

New research from Rush University in Chicago suggests that belief in a caring God can improve people's response to treatment for depression. Previous research has suggested that religious belief can help prevent people developing depression in the first place but this is the first study to show that it can help people recover more quickly from it. The study of 136 adults diagnosed with major depression or bipolar depression found that those with strong beliefs in a personal and concerned God were more likely to experience an improvement. Participants who scored in the top third of the Religious Well Being Scale were 75% more likely to get better with medical treatment for clinical depression. The improved response of the people with a belief in a caring God was not linked to feelings of hope engendered by religion but was tied specifically to a belief that a Supreme Being cared.

You can find out more about this research at

Obesity and cognitive function

A forty-year study of Swedish twins between 1963 and 2002 has found that those who had a higher body-mass-index when they were middle-aged had 'significantly lower general cognitive ability' and 'significantly steeper decline' than their thinner counterparts over time. The study - headed by Anna Dahl, from Jonkoping University in Sweden - found the same results for men and women and that obesity was particularly damaging where there were other health problems such as poor muscle strength or depression.

You can find out more about this research at

Depression, obesity and stress

Cortisol is a hormone that is produced in reaction to stress. It is also produced more when people are depressed and plays a role in regulating people's metabolisms. There is thought to be a link between depression, cortisol and obesity but no-one is quite sure how this works. A team of researchers from Penn State University in the U.S. looked into this issue in a sample of 111 boys and girls between 8 and 13. The children were assessed for their levels of depression, weighed and measured and had their cortisol levels taken before and after an assessed maths test designed to raise their stress levels. The children who were more depressed showed a higher increase in their levels of cortisol after being stressed but this was only associated with obesity in the case of the girls.

You can find out more about this research at

Tuesday, February 23, 2010

Omega-3s and psychosis

Early intervention has been found to lead to much better results for people with schizophrenia and psychosis. This often takes the form of antipsychotic drugs but they have serious side effects and their use is controversial in people who have yet to develop full-blown psychosis. A team of researchers led by Dr G. Paul Amminger from the University of Vienna studied the use of omega-3 polyunsaturated fatty acids in 81 people at 'ultra-high risk' of psychotic disorder. Half got the omega-3 and half got a placebo. By the end of the study only 4.9% of the people in the omega-3 group had developed psychosis compared to 27.5% in the placebo group. The omega-3s also significantly reduced symptoms and improved functioning with no more side effects than the placebo.

Amminger, G. Paul ... [et al] - Long-chain omega-3 fatty acids for indicated prevention of psychotic disorders: a randomized controlled trial Archives of General Psychiatry February 2010, 67(2), 146-154

Exercise, schizophrenia and growing your hippocampus

Neural plasticity is the brain's ability to change and adapt over time. People with schizophrenia show changes in their brains and it could be the case that they have less neural plasticity than other people. People with schizophrenia also have smaller hippocampi than other people. Exercise is known to stimulate growth in the hippocampus and a team of researchers led by Dr. Frank-Gerald Pajonk from Liebenburg in Germany set out to test this in a study of 32 people, 24 of whom had schizophrenia. Some of the participants did cycling to boost their fitness while the rest played table football. After three months those healthy controls who did exercise showed a 16% increase in the volume of their hippocampi while those people with schizophrenia who exercised showed a 12% increase; whereas the people who played table football's hippocampi actually shrank by 1%. The more people's fitness improved the greater the increase in the size of their hippocampus and the more people's hippocampi grew the more their scores for short-term memory improved.

Pajonk, Frank-Gerald ... [et al] - Hippocampal plasticity in response to exercise in schizophrenia Archives of General Psychiatry February 2010, 67(2), 133-143

Stereotype threat, social skills and schizophrenia

Stereotype threat is the feeling that one is the target of demeaning stereotypes and has been found to affect performance among a number of different people doing a number of different tasks. Interestingly people do not have to actually be treated in a negative way for this effect to occur, they just have to believe they are being stereotyped. People with schizophrenia are often thought to have poor social skills and a team of researchers from the University of New South Wales and the University of Queensland wondered whether this could be due to stereotype threat. They got 30 people with schizophrenia to talk to two 'confederates.' The people with schizophrenia were told that one of the confederates knew about their diagnosis while the other didn't; but in fact neither of the confederates knew that they were talking to someone with schizophrenia. Although the participants with schizophrenia did not perceive any differences in their own social behaviour those confederates who talked to someone who thought the confederates knew about their mental-health problems rated the participants' social skills as poorer.

Henry, Julie D., von Hippel, Courtney and Shapiro, Lisa - Stereotype threat contributes to social difficulties in people with schizophrenia British Journal of Clinical Psychology March 2010, 49(1), 31-41

CBT and learning disabilities

People with learning disabilities suffer from mental-health problems as much as, if not more than, other people. Cognitive behaviour therapy has been found to be effective for a number of different mental-health problems but it is unclear whether people with learning disabilities are able to grasp the links between thoughts, feelings and behaviour that they need to understand in order for the therapy to be effective. Researchers from the University of East Anglia and Norfolk Primary Care NHS Trust looked into this issue in a study of 34 adults with learning disabilities. 18 of them were given training in distinguishing between thoughts, feelings and behaviours and in linking thoughts and feelings while the rest of the participants went to a relaxation class. The study found that the training led to significant improvements in the particpants' abilities to link thoughts and feelings, skills that could then be applied to new situations. However, the training had no effect on the participants' ability to distinguish between thoughts, feelings and behaviour.

Bruce, Melanie ... [et al] - Does training improve understanding of core concepts in cognitive behaviour therapy by people with intellectual disabilities? A randomized experiment British Journal of Clinical Psychology March 2010, 49(1), 1-13

Friday, February 19, 2010

Alcohol and bipolar disorder

Researchers from the University Medical Centre in Amsterdam have been looking into the effects of alcohol consumption on people with bipolar disorder. They studied 137 people with bipolar disorder. 44 drank very little or nothing at all, 49 were moderate drinkers who drank less than the Government's recommended amount and 44 were heavy drinkers who drank more than this. The participants kept diaries of their moods for at least two months. Contrary to expectations the group of heavy drinkers did not have a greater number of depressed days, mood swings or other symptoms than the occasional or moderate drinkers. 90% of the sample took their medication regularly and none of them had any other health problems so these factors may have lessened the impact of the alcohol. The study was a small-scale one and it is not a good idea to drink more than the recommended limits of alcohol - even if there is no impact on bipolar disorder!

You can find out more about this research at

Holidays and happiness

Holidays can make you happy before you go on them but have little long-lasting effect once you get back. Researchers from Erasmus University in Rotterdam studied 1,530 people, 974 of whom went on holiday during the study period. They found that those people who were planning a holiday were happier than other people due to the anticipation of their break. For most people there was no difference in happiness after the holiday between those people who had been away and those who hadn't. People who had had a very relaxing holiday were a little happier for the first two weeks afterwards but the effect had completely worn off after eight weeks.

You can find out more about this research at

Cognitive insight and psychosis

Cognitive insight is the ability to self-reflect, realise that beliefs may be mistaken and consider feedback from other people. Lack of it is thought to play an important role in the development and continuation of psychosis, and a team of researchers from the University of Pennsylvania and the Institute of Psychology, King's College London looked into the influence of cognitive insight on the progress of 78 outpatients being treated for psychosis with cognitive behaviour therapy. They found that people with more cognitive insight had less severe delusions after treatment and that people whose cognitive insight improved over the course of their treatment had 'clinically significant reductions' in the severity of both delusions and auditory hallucinations by the end of their therapy.

Perivoliotis, Dimitri ... [et al] - Cognitive insight predicts favourable outcome in cognitive behavioral therapy for psychosis Psychosis February 2010, 2(1), 23-33

Thursday, February 18, 2010

Military veterans still not getting PTSD care

Many military veterans in the U.S. are still not getting the treatment they need for post-traumatic stress disorder (PTSD). Dr Karen Seal from the San Franciscon Veteran Affairs Medical Centre lead a team studying this issue. They found that between 2002 and 2008 nearly 50,000 veterans from the Iraq and Afghanistan wars received a diagnosis of PTSD. However, fewer than 10% of them completed the recommended treatment of 10-12 weekly sessions within four months of being diagnosed, and even after a year only 30% had. Men, veterans under the age of 25, those who lived in rural areas and those who got their diagnosis at primary-care clinics were less likely to receive recommended care.

You can find out more about this issue at

Flexible working and mental health

A team of researchers led by Clare Bambra from Durham University have been reviewing studies into the health benefits of flexible working. They reviewed ten studies which included a total of 16,603 people. Flexible working was found to have a positive effect on a number of health outcomes including blood pressure, sleep and mental health.

You can find out more about this research at

A happy heart is a healthy heart

Being happy could reduce your risk of developing heart disease. Researchers from Columbia University Medical Centre in New York assessed 1,739 adults at the start of the study. They recorded their general health and measured symptoms of depression, hostility, anxiety and the degree to which they expressed positive emotions. They then tracked the participants' health over the next ten years. The study found that for each point scored on a 'positivity' scale the risk of developing heart disease over the next ten years dropped by 22%.

You can find out more about this research at

Mindfulness and the military

Cultivating mindfulness - the ability to be aware and attentive to the present moment without emotional reactivity or volatility - has proved helpful for people with anxiety and depression and a new study by researchers from the University of Pennsylvania and Georgetown University has found it can also be useful for the Marines. 48 Marine reservists took part in the study. 31 of them did Mindfulness-based Mind Fitness Training and 17 did not. The programme blended mindfulness skills training and information and skills aobut stress, trauma and resilience in the body. The group who did the mindfulness training showed an increase in working memory capacity and a decrease in negative mood over the eight-week course in contrast to the control group who showed a decrease in working memory and an increase in negative mood over the same period.

You can find out more about this research at

Wednesday, February 17, 2010

Stockholm syndrome - guest post by Pamelia Brown

Stockholm Syndrome - Media Frenzy or Legitimate Disorder?

In August 2009, when Jaycee Dugard, a woman kidnapped 18 years ago, was found, the media reported that she displayed symptoms of the psychological disorder known as Stockholm Syndrome, so named after a famous Swedish robbery in which hostages sympathized with their captors. Housed in a shed in her captor’s backyard, Dugard was repeatedly raped since she was eleven years old. But when investigators questioned her, Dugard reported that her captor was a “great person.”

Dugard’s case is only one of the many news stories that have received worldwide media attention. The public is fascinated by victims’ seemingly inexplicable positive responses after having suffered physical, emotional, and sexual abuse.

In her groundbreaking book, Loving to Survive: Sexual Terror, Men’s Violence, and Women’s Lives, Dr. Dee Graham, one of the earliest Stockholm Syndrome researchers, identified four characteristics that typify those suffering from the syndrome:

1. Perceived threat to survival, and belief that the captor is able to carry out the threat at any time.
2. A captor carries out a small act of kindness, and the captive perceives it as redemptive.
3. The captive is isolated for a significant amount of time, such that the victim can only see through the captor’s perspective.
4. Perceived impossibility of escape.

Shirley Julich, a professor at the Auckland University of Technology in New Zealand, focuses her research on child sexual abuse. In 2005, she wrote a comprehensive report analyzing interviews with 21 survivors of childhood sexual abuse. In her attempt to understand her interviewers’ initial reticence to report abuse, she turned to Graham’s research, concluding that Stockholm Syndrome was indeed a major culprit, in effect contradicting an earlier child sexual abuse study conducted by the Otago Women’s Health Survey.

Shirley Julich’s full report is available here.

To read a more in-depth description of Stockholm Syndrome symptoms, read Dr. Joseph Carver’s Mental Health Matters blog post .

To get a brief history of major news stories featuring victims suffering from Stockholm Syndrome, read this recent Time magazine article.

This guest post is contributed by Pamelia Brown, who writes on the topics of online associate degree programs . She welcomes your comments at her email Id:

Tuesday, February 16, 2010

Dyadic discord and depression

Psychologists rarely use a simple word where a complicated one will do and dyadic discord is their term for not getting on with your spouse or partner. A team of researchers, led by Wayne Denton from the University of Texas, looked at 171 people with partners who were being treated for long-term depression. The participants were treated with nefazodone, the Cognitive Behavioural Analysis system of psychotherapy or a combination of both. The happiness of the participants' relationships and their levels of depression were measured before, during and after treatment. Participants with dyadic discord at the start of the study had much lower remission rates (34.1%) than those with happier relationships (61.2%).

Denton, W.H. ... [et al] - Dyadic discord at baseline is associated with lack of remission in the acute treatment of chronic depression Psychological Medicine March 2010, 40(3), 415-424

Cynical hostility and depression

Cynical hostility is a personality trait characterised by general cynicism and mistrust in interpersonal relationships. It is believed to be associated with an increased risk of depression but few large-scale studies have been carried out. Researchers from France and University College London used data from a long-term study of 3,399 Whitehall civil servants. They filled out questionnaires to measure their level of cynical hostility at the start of the study (1985-1988) and their levels of depression were measured later (2002-2004). Even after adjusting for other factors the participants in the top quarter for levels of cynical hostility were over four-and-a-half times more likely to be depressed in 2002-4 than those in the bottom quarter.

Nabi, H. ... [et al] - Hostility and depressive mood: results from the Whitehall II prospective cohort study Psychological Medicine March 2010, 40(3), 405-413

How to tell and what to do if clients go downhill

About 5-10% of people actually get worse after starting psychotherapy. Studies comparing therapists who got feedback when their clients worsened showed that their clients did better than those people with therapists who were left to carry on regardless - suggesting that not all therapists know when their clients are going downhill. Researchers from the Indiana University of Pennsylvania looked into this issue by giving questionnaires to clients to assess their mental state and comparing them with the therapists' own notes. They found that 'therapists had considerable difficulty recognising client deterioration.' Other therapists were asked how they would judge if a client was going downhill and most replied that they would judge from their clients' symptoms rather than using a standardised rating scale. The most popular options for what to do if a client worsened were to make a referral for medication, to increase the frequency of therapy sessions, to gather more information, to discuss the deterioration with the client, to counsult other therapists and to change the treatment approach in some way.

Hatfield, Derek ... [et al] - Do we know when our clients get worse? An investigation of therapists' ability to detect negative client change Clinical Psychology and Psychotherapy January-February 2010, 17(1), 25-32

PTSD and shame

The main emotion associated with Post-Traumatic Stress Disorder (PTSD) is fear but researchers are now starting to look at the way in which other emotions can play a part in maintaining the condition. One such emotion is shame caused when, rather than seeing the world as a more dangerous and threatening place after traumatic events people blame themselves and see themselves as weak and incompetent for allowing them to happen. Researchers from St George's hospital in London looked into the role of shame in a study of 49 people with PTSD. They found that those people with higher levels of shame were more prone to engage in self-criticism and less prone to engage in self-reassuring thinking than people with lower levels of shame.

Harman, Rachel and Lee, Deborah - The role of shame and self-critical thinking in the development and maintenance of current threat in post-traumatic stress disorder Clinical Psychology and Psychotherapy January-February 2010, 17(1), 13-24

Monday, February 15, 2010

Antidepressants and premature birth

Some studies have found a link between premature births and the use of antidepressants during a mother's pregnancy. There is still a shortage of evidence on this topic but another study by researchers at the Hospital for Sick Children in Toronto has added to the evidence that there might be a link. The study compared 928 women who had taken antidepressants during their pregnancy with 928 women of similar health and background who had not. It found that 8.8% of the women who had taken antidepressants had had a premature baby, compared to only 5.4% of the women in the comparison group. However, women taking antidepressants were no more likely to give birth to babies who were small for their gestational age or who had a low birth weight.

Einarson, A. ... [et al] - Adverse effects of antidepressant use in pregnancy: an evaluation of fetal growth and preterm birth Depression and Anxiety January 2010, 27(1), 35-38

Anxiety does not affect effectiveness of duloxetine

Some studies have suggested that people who suffer from anxiety as well as depression respond less well to treatments with antidepressants. J. Craig Nelson from the University of California, San Francisco reviewed 11 studies into the effectiveness of duloxetine at treating depression. The studies covered a total of 2,841 people of whom 1,326 were classified as anxious. Duloxetine was found to be more effective than a placebo and have better response and remission rates, and the drug was just as effective for people with anxiety.

Nelson, J. Craig - Anxiety does not predict response to duloxetine in major depression: results of a pooled analysis of individual patient data from 11 placebo-controlled trials Depression and Anxiety January 2010, 27(1), 12-18

Psychopathy, guilt and responsibility

One of the main features about psychopathy is that people feel little sense of responsibility for, or guilt about, their actions. Researchers, led by Amy Batson from the South London and Maudsley NHS Trust, looked into these issues in a sample of 67 men held at six medium-secure units in the South-East of England. There was found to be a 'significant positive correlation' between psychopathy and blaming other people but there was no link between pscyhopathy and people's feelings of guilt.

Batson, Amy, Gudjonsson, Gisli, and Gray, Jacqueline - Attribution of blame for criminl acts and its relationship with pschopathy as measured by the Hare Psychopathic checklist (PCL-SV)

Borderline personality disorder and sleep problems in prison

Borderline personality disorder (BPD) is characterized by impulsiveness, unstable moods, relationship difficulties and low self-esteem. People with BPD are more likely to take drugs, behave antisocially and self-harm and are at much greater risk of getting into trouble with the law. Scientists think that only 1-2% of the population as a whole have BPD but this rises to 23-30% of people in prison. People with BPD who are in prison often have sleep problems but it is unclear whether it is the BPD itself of the depression that often goes with it that causes these. Researchers from George Mason University in Virginia studied 513 prisoners and found that symptoms of BPD were significantly associated with sleep problems even after allowing for the effects of depression. Drug use did not affect the link between BPD and depression. Depression was also associated with sleep disorders but again this link was independent of whether people were taking drugs or not.

Harty, Laura ... [et al] - Are inmates' subjective sleep problems associated with borderline personality, psychopathy, and antisocial personality independent of depression and substance dependence? Journal of Forensic Psychiatry and Psychology February 2010, 21(1), 23-38

Friday, February 12, 2010

New website launched for psychosis carers

A new website giving straightforward information, advice and support to relatives and friends of people with psychosis – including people who have schizophrenia and bipolar disorder – was launched on the 8th of February.

The Institute of Psychiatry, King’s College London, the South London and Maudsley NHS Foundation Trust and Rethink, the mental health charity that runs support groups for carers, worked together to set up the site and the Wellcome Trust gave a grant to pay for its development.

People looking after friends or relatives with psychosis want accurate, reliable information which they can get easily and quickly. Although there are lots of websites about psychosis on the internet, there are not many British ones, and even less that are reliable. Many of the sites say completely different things so it is hard to know who to believe.

The new site aims to solve these problems by providing:

• short films of interviews with health professionals and researchers talking about different aspects of psychosis, treatment and care
• Ask the Pharmacist, Ask the Psychologist and Ask the Psychiatrist pages where visitors to the site can submit general questions
• summaries of IoP research about psychosis, written in plain English
• information on how to get involved with research
• links to other useful websites.

All the information on the website is based on research carried out to learn more about the causes of psychosis, develop new treatments or improve existing ones. Researchers from the IoP and mental health professionals from SLAM provide information for the site which is easy to find your way around, clearly laid out and written in plain English. It uses simple language and explains mental health terms; gives information about drugs and their side effects; describes other treatments, such as psychotherapy and explains how mental health services work.

Tuesday, February 09, 2010

Yes, you can be bored to death

Being bored might make life seem longer but it can actually shorten it in the long run. Researchers at University College London have been monitoring over 7,000 civil servants over 25 years as part of a long-term study of lifestyle and health. The civil servants who were aged between 35 and 55 at the start of the study were interviewed about their levels of boredom in the mid 1980s. Those with the highest levels of boredom were most likely to have died by the end of the study, perhaps because they had turned to drink, drugs or smoking to alleviate their boredom. Women, younger employees and those with menial jobs were all more likely to be bored at work.

You can find out more about this study at

Twist or stick? Why it might all be down to the amygdala

Most people are reluctant to gamble if the potential losses outweigh the gains; something psychologists call loss aversion. Scientists think a part of the brain called the amygdala might play an important part in loss aversion and researchers at the California Institute of Technology studied two people who had suffered damage to this area. At the start of the experiment the participants, who also included twelve healthy controls, were given $50 to gamble on the toss of a coin. The ratio of what they would win to what they could lose was varied and when the risks outweighed the opportunities the healthy controls stopped gambling. However, the people with the damaged amygdalas carried on gambling whatever the risks confirming the theory that the amygdala does play a role in this process.

You can find out more about this research at

Feeling secure on the streets of Sweden

Swedish researchers have been looking into the factors that make people afraid to walk the streets at night. Researchers from the University of Gothenburg carried out a series of studies into this issue. They found that young people who had experienced threats and violence felt more insecure than others, particularly when they were on their own. Being alone was a strong factor in people's insecurity. Being with friends and acquaintances made people feel most secure but even being surrounded by strangers made people feel safer. Younger people actually felt more insecure than older ones. The research also looked at how people's beliefs about the media influenced their perception of danger. They found that people who thought the media under-reported crime thought that the streets were more dangerous than those who thought the media was accurate or that it exaggerated crime.

You can find out more about this research

Older parents and autism

Putting off having a child until later in life could increase the child's risk of developing autism. Increasing numbers of men and women are starting families later in life. Researchers from the University of California Davis looked at the records of all births in California between 1990 and the end of 1999 - a total of about 4.9 million births including 12,159 cases of autism. They found that a 40-year-old mother's risk of having an autistic child was 50% greater than that of a woman giving birth between the ages of 25 and 29. The father's age was only a factor when the mother was young. Fathers over 40 were twice as likey to have an autistic child if the mother was under 25 than fathers who were between 25 and 29. Some of the reasons put forward by the researchers to explain this were that sperm and egg quality declined with age and that environmental toxins accumulate in parent's bodies over time. But the risk of having a child with autism is still very low whatever age parents are.

You can find out more about this research at

Mediterranean diet could stave off Alzheimer's

The Mediterranean diet is good for you in all sorts of ways and a new study by researchers at Columbia University Medical Centre in New York has found that it can help stave off memory problems as well. The researchers studied 712 people and divided them into three groups depending on how closely they stuck to a Mediterranean diet high in vegetables, fruit, cereals and fish. Six years later they carried out MRI brain scans on the volunteers looking out for damage to areas of the brain that deal with memory. Those participants who followed the Mediterranean diet most closely were 36% less likely to have damage in these areas than those who stuck to a 'North European' diet high in dairy products, meat and chicken and with a moderate intake of alcohol. The researchers next project might be to work out a way to make broccoli, kiwi fruit and herbal tea taste as nice as chocolate, chips and whisky!

You can find out more about this study at

Monday, February 08, 2010

Depressed mothers and violent teenagers

Mothers who are depressed during their pregnancy may have children who are more aggressive than others and may also have been more aggressive as teenagers themselves. Researchers from Cardiff University, King's College London and the University of Bristol studied 120 children and interviewed their mothers while they were pregnant, after they gave birth and again when their children were 4, 11 and 16. The mothers who were depressed when they were pregnant were four times as likely to have children who were violent at 16. The mothers' depression was predicted by their own aggressive and disruptive behaviour as teenagers.

You can find out more about this research at

Family therapy and teenage depression

Family therapy can help to reduce suicidal thoughts and depression in adolescents. Suicide is the third leading cause of death in American teenagers, accounting for more than 1,300 deaths in children between the ages of 12 and 18 in 2005. Researchers from the Children's Hospital of Philadelphia studied 66 children aged between 12 and 17 who were suffering from suicidal thinking and depression. Some received Attachment-based Family Therapy while others received 'treatment as usual' in the community. By the end of the treatment those children who had had family therapy - which aims to resolve family conflicts and promote family strength - were four times more likely to have no suicidal thinking. They also showed a more rapid decrease in depression symptoms and were more likely to stay in treatment longer.

You can read more about this research at

Excess mortality and schizophrenia

As a group, people with schizophrenia have a higher death rate than other people; something that has been proved in a number of different populations, continents and time periods. In Scandinavia the number of excessive deaths among schizophrenic people has actually increased since the 1970s but it is not known if this trend holds true in the U.K. A team of researchers from the University of Southampton studied 370 people with schizophrenia who had had contact with local NHS services between 1981 and 1982 and looked to see how many of them had died, and of what, by 2006. The researchers found that people with schizophrenia had a 2.89x greater risk of dying over this period than people in the rest of the population. Deaths from suicide were concentrated in the first five years after people had come into contact with psychiatric services but most of the excess mortality was due to natural causes. There was an 'indication' that deaths from cardiovascular disease may have increased in frequency relative to the rest of the population over the course of the study.

Brown, Steve ... [et al] - Twenty-five year mortality of a community cohort with schizophrenia British Journal of Psychiatry February 2010, 196(2), 116-121

Befriending for depression

Over 500 charities in the U.K. offer befriending to people where volunteers meet up with people to go for walks, see films, play snooker and a host of other activities. Lack of social support is known to be a risk factor for depression and a team of researchers led by Nicola Mead from the University of Manchester reviewed 24 studies into the effects of befriending schemes on people's depression symptoms. They found that compared with usual care or no treatment befriending had a modest but significant effect on depression symptoms.

Mead, Nicola ... [et al] - Effects of befriending on depressive symptoms and distress: systematic review and meta-analysis British Journal of Psychiatry February 2010, 196(2), 96-101

Friday, February 05, 2010

Genes, bullying and depression

Scientists are discovering more and more information about the way in which people's genes and environment interact to affect their health. A study of 78 girls by researchers at Stanford University in Palo Alto, California looked into the links between bullying, depression and a variation in a gene called 5-HTTLPR. Between 20-40% of children report bullying of some kind and 3-8% of children report frequent victimization. Bullying has been linked to depression, anxiety, loneliness and low self-esteem and girls are both more likely to suffer from it and to be more severely affected by it while variations in the gene 5-HTTLPR have been linked to an increased vulnerability to depression. So, the study asked the children about their mental health and whether they had been bullied and also tested them to see which variation in the gene they had. The researchers found that the genetic variation did not influence the children's levels of depression on its own. However, of the girls who had been bullied only those with the genetic variation were significantly more likely to develop depression.

Benjet, Corina, Thompson, Renee J. and Gotlib, Ian H. - 5-HTTLPR moderates the effect of relational peer victimization on depressive symptoms in adolescent girls Journal of Child Psychology and Psychiatry February 2010, 51(2), 173-179

Obesity and ADHD

Recent research has suggested that there is a link between mothers who are obese before they become pregnant and their children's risk of developing ADHD (Attention Deficit Hyperactivity Disorder). This could be down to a number of factors. Mothers may gain weight because they are stressed and it is their stress rather than their weight problems that lead their children to develop ADHD; there may be a common genetic factor linking a tendency to obesity in mothers with a tendency towards ADHD in their children or obese mothers may be more likely to have obese children and it is the children's obesity that makes them more likely to have ADHD. Alina Rodriguez from Uppsala University in Sweden looked into this further in a study of 1,714 children and their mothers who were monitored from before the mother's pregnancy until their children were five. The study took into account the mother's circumstances (smoking, depression, 'life events', education, age and family structure), the child's birth weight and gestational age, whether the child was a boy or a girl, whether the parents had ADHD and if the child was overweight. Even after allowing for all these factors mothers who were overweight or obese before becoming pregnant were more likely to have children with attention problems. Being obese before becoming pregnant was associated with a doubling in the risk of one's children developing problems with 'emotional intensity' and managing emotions.

Rodriguez, Alina - Maternal pre-pregnancy obesity and risk for inattention and negative emotionality in children Journal of Child Psychology and Psychiatry February 2010, 51(2), 134-143

Thursday, February 04, 2010

Suicide and genetics

It is estimated that between 10 and 20 million people a year try and kill themselves with around one million succeeding. Previous studies have shown that there is a genetic influence on suicide and that suicides tend to cluster in families. Researchers from the Max Planck Institute of Psychiatry in Munich studied three different groups of people in an attempt to find genes that might be associated with an increased risk of suicide. They studied 760 people in Germany. 394 of them were depressed of whom 113 had tried to kill themselves. They also studied another 744 German people being treated for depression, 152 of whom had attempted suicide. Finally they studied 921 African Americans who were attending a clinic for physical health problems - 119 of them had attempted suicide. The researchers found five genetic variations that were associated with an increased risk of suicide. For people with the three most significant variations there was a 4.5x greater risk of attempting suicide.

You can find out more about this research at

Acupuncture for depression in pregnancy

About 10% of pregnant women meet the criteria for major depression and almost 20% have increased symptoms of depression during their pregnancy. These rates are about the same as other women but researchers can sometimes be reluctant to study treatments for pregnant women with depression in case they affect mother's babies. Dr Rosa Schnyer from the University of Arizona researched the effectiveness of acupuncture in treating depressed pregnant women. She divided the women into three separate groups. One group received acupuncture to treat their depression, another group received a different acupuncture treatment and a third group had some massage. After eight weeks the women who had received acupuncture for depression showed a significantly greater decrease in the severity of their depression and had a higher response rate to treatment than the other two groups.

You can find out more about this research at

Wednesday, February 03, 2010

Brighter children at higher bipolar risk

Children who do better at school are more likely to develop bipolar disorder later in life. Researchers from King's College London and the Karolinska Institute in Gothenburg looked at the exam results of more than 700,000 Swedish teenagers and compared them to their later medical history. They found that those children with the highest performance were nearly four times as likely to develop bipolar disorder as those with average grades. Children with the poorest grades were twice as likely to develop bipolar disorder in adulthood as those with average grades. The link between high grades and bipolar disorder was particularly strong for creative subjects such as Swedish or music. People who suffer from bipolar disorder often experience extra energy, creativity and ability to connect ideas during the manic phase of their illness although mania can lead to inappropriate, dangerous or excessive behaviour. It is also worth remembering that on the whole people who do well at school tend to have better mental health than other people.

You can find out more about this research at

Clarkson is right say psychologists

In research guaranteed to gratify ageing petrol heads psychologists from the University of Wales Institute in Cardiff have found that a prestigious car really can make men seem more attractive. People in Cardiff city centre were asked to rate the attractiveness of men and women. The pictures were all of the same man or woman but half the time they were pictured in a Bentley and half the time they were pictured in a Ford Fiesta. The women who saw the man in a Bentley rated him as more attractive than the women who saw him in a Ford Fiesta. However, the men rated the women as equally attractive regardless of whether they saw her in a Bentley or a Fiesta.

You can find out more about this research at

Tuesday, February 02, 2010

Lack of treatment for depressed people in the U.S.

Most Americans with depression are not receiving adequate treatment and this situation is particularly bad among Mexican Americans and African Americans. A team of researchers led by Hector M. Gonzalez from Wayne State University in Detroit studied 15,762 people from all over the 48 states of mainland America. They assessed the severity of their depression using questionnaires and asked people whether they had received treatment in the last year. Despite having symptoms that were just as bad depressed Mexican Americans and Africa Americans received less treatment than other group. All groups used more psychotherapy than drugs and this bias was particularly strong in Caribbean black and African American people.

Gonzalez, Hector M. ... [et al] - Depression care in the United States: too little for too few Archives of General Psychiatry January 2010, 67(1), 37-46

Polypharmacy and psychiatry

Polypharmacy is prescribing more than one drug to the same patient for the same condition. It is recommended in some situations but in others drugs can work together to cause side effects and polypharmacy also adds to the costs of medical treatment. Researchers from Johns Hopkins University in Baltimore and Columbia University in New York analyzed 13,079 visits to psychiatrists in the U.S. between 1996 and 2006. They found that visits to the psychiatrist in which two or more drugs were prescribed rose from 42.6% in 1996/7 to 59.8% in 2005/6. Prescriptions for two or more antidepressants, antipsychotics, sedatives/hypnotics and antidepressant-antipsychotic combinations significantly increased across the period of the survey. The odds of prescribing two or more antidepressants were significantly associated with major depression, two or more antipsychotics were associated with schizophrenia, two or more mood stabilizers with bipolar disorder and two or more sedative/hypnotics with anxiety disorders.

Mojtabai, Ramin and Olfson, Mark - National trends in psychotropic medication polypharmacy in office-based psychiatry Archives of General Psychiatry January 2010, 67(1), 26-36

EMDR for traumatised children

Trauma-focused cognitive therapy has been shown to be effective in treating post-traumatic stress disorder (PTSD) in children and adolescents after physical and sexual abuse but there are fewer treatments for children who have suffered a single, severe trauma such as a car accident. Eye Movement Desensitization and Reprocessing (EMDR) has been found to be effective in some cases of PTSD and a team of Australian researchers led by Michael Kemp from Murdoch University looked into EMDR in a study of 27 children aged between 6 and 12. The children were all suffering from persistent PTSD symptoms after a car accident. Half the participants were allotted to an EMDR group and the others were put on a waiting list. At the start of the study all of the children had two or more symptoms of PTSD but after treatment only 25% of the children in the EMDR group did compared to all those on the waiting list. However, the parents' rating of their children's PTSD symptoms showed no difference between the two groups and nor did other symptoms such as depression and anxiety. So, the jury is still out on EMDR as a therapy for this group of children.

Kemp, Michael, Drummond, Peter and McDermott, Brett - A wait-list controlled pilot study of eye-movement desensitization and reprocessing (EMDR) for children with post-traumatic stress disorder (PTSD) symptoms from motor vehicle accidents Clinical Child Psychology and Psychiatry January 2010, 15(1), 5-25